Mock Nutrition Counseling Experience

Erin Sevilla

Observed by: Zainab Khalid

(October 16, 2018)

DFM 655

October 24, 2018

 I. Introduction

Client was a female senior college student attending SFSU. She lived off campus with

her boyfriend, in Oakland. Her commute time was 45 min- 1 hr. to school traveled

usually by car and sometimes on BART. She worked as a nanny for young

children-giving her the increased opportunity to cook meals for herself and the children.

The client is a graduating college student who also works. That being said, she expressed

her concern for her busy lifestyle interfering with her time to meal prep and eat a varied

balanced diet. She sometime/rarely buys food out or on campus. The client has recently

(within last 5 years) switched to a pescatarian diet and relayed she had an anemic concern

at the beginning of her transition. Because of the anemic concern, iron rich foods

complemented with vitamin C rich foods were suggested (Lane & Richardson, 2014).

Non meat protein sources like legumes, nuts, grains were also stated as a response to the

client wanting a more complete diet (​Chalvon-Demersay et al, 2017​).

II. Case Report

The client was upbeat and friendly. She was excited to explore into her diet and make a

change, exhibiting signs of precontemplation or contemplation already . However,

finding out what my client wanted to change exactly was difficult. The involving phase

flowed smoothly right into the exploration phase, it was very conversation like and made

the client and myself feel comfortable and relaxed- which was evident by her body

language and composition. Many open-ended questions were asked and some barriers
 were discovered, i.e. transportation, cooking for two. Then we moved into the 24hr diet

recall, this took a little longer as it should. I felt the confident, upbeat attitude of my client

put her in the contemplation phase, she even showed the determination of a level 3, ready

for action. My reaction to the clients positive attitude was supportive and encouraging

and, I’m hoping, made her feel more confident in the choices she was making and the

knowledge she already had. After asking for permission to share education information,

we moved on to the education phase. Where we discussed eating a balanced diet and

ways to increase iron and it’s absorption. The client seemed curious to the information

presented her and wanting to learn more about the different variety of foods shown and

ways to incorporate them. We next transitioned into the resolving phase to make a

SMART goal. This seemed the most challenging part and had to be rewritten a few times,

until we found what suited the clients needs and wants the most. She expressed that she

was fairly high on the assessment scale, but her lack of time prevented her from being a

10/10. The client was promoted with supportive conversation to increase her self efficacy

and increase her likelihood of making a dietary change.

III. Discussion

The client came in with a well determined attitude, curious attitude which swayed me to

lean towards a social determination model to change behavior. So, the goal was to

enhance and support her desire to make an improvement. However, as a counselor, I felt I

was too preachy. I didn't leave enough space for silence and during the education phase

my organization slipped away from me and so did my nerves. Instead of facilitating the

client to come up with the goal or idea on her own, I spouted ideas and suggestions at her.
I think I was just trying to fill space and talk. Although I know this isn't the right way to

go, especially for social determination theory where the client is meant to thrive through

their own strengths and independence. During the education phase of the social

determination theory I enhanced the clients need for competency by educating her on the

increased absorption rate of iron when paired with vitamin C (Lane, 2014). I gave her a

few examples and told her where she could include these combinations in her diet. Next

time maybe I will give some suggestions of the iron-vit C complex and ask the client

where they could see one of them fitting in their diet. I should let them choose where to

input these dietary changes rather than telling the or directing them myself. I attempted to

support the need for autonomy by showing her the list and balanced diet chart. Then I

asked her to circle foods she's never heard of, to increase her awareness of the variety of

food available and what macronutrient they fall under. We discussed grocery shopping

and how she could enhance the variety of her diet by choosing one unusual food and

trying to cook with it. I suggested her making a fun adventurous food day of it by going

with her boyfriend to the store and trying a new recipe. however, I feel I may have been

to forward in suggesting this. The client seemed excited so I wanted to challenge her a

bit. Looking back, I should have let her challenge herself- especially when following the

social determination model. A major objective is for the client to feel autonomy and I feel

I may have taken some of that away by making so many suggestions, rather than letting

her come to conclusions on her own. I need to work on facilitating and paraphrasing

more. I paraphrased a bit but felt it difficult and unnatural. I need to practice paraphrasing

more, rather than relying on my friendly personality to communicate with people. I

 thought I would be able to automatically insert these skills, but I’ve discovered I need a

bit more practice before I’m totally confident doing this again .

IV. Conclusion

The overall mock nutrition counseling went well. Initially, I thought I made a lot of

mistakes and kinda beat myself up about it. However, I realized that clients are not going

to know what they want instantly and you will have to poke and prod to get information

out of them- even if they are super talkative. I felt I jumped the gun on a few things and

should have left more space for silence and took my time a little more overall. The client

expressed moving to a pescatarian diet and concerns about past anemia, so we discussed

iron rich foods and how to pair them with vitamin C rich foods to increase absorption.

The client was searching for a more balanced and varied diet. She explored a chart of

different foods categorized by macronutrients and explained to ensure all groups in each

meal with added bonus for a variety of colored foods for a rainbow plate.
 References

Chalvon-Demersay, T., Azzout-Marniche, D., Arfsten, J., Egli, L., Gaudichon, C.,

Karagounis, L. G., & Tomé, D. (2017). A Systematic Review of the Effects of Plant

Compared with Animal Protein Sources on Features of Metabolic Syndrome. ​The Journal

of Nutrition​. doi:10.3945/jn.116.239574

Lane, D. J., & Richardson, D. R. (2014). The active role of vitamin C in mammalian iron

metabolism: Much more than just enhanced iron absorption! ​Free Radical Biology and

Medicine,75​, 69-83. doi:10.1016/j.freeradbiomed.2014.07.007